ADVERSE REACTIONS AND DRUG TOXICITY ( pharm)

What population are more prone to Adverse effects?

very young and very old

What are the adverse effect that can happen to the CNS?

•Can cause stimulation (excitement) or depression.

- not being able to drive/operate heavy machinery.

What are Anticholinergic?

a class of drugs that block the action of a neurotransmitter called muscarinic receptors. Often in eyes, smooth muscle, exocrine glands, and heart.

What Adverse effects can happen with Anticholinergics?

Patients can experience dry mouth, photophobia, urinary retention, constipation

What should the nurse do to aid the adverse effects of Anticholinergics?

•Have patients sip fluids for dry mouth, wear sun glasses, increase fiber and fluids.

What are the Adverse effects in Cardiovascular system?

Involves blood vessels in the heart (ie: Antihypertensives can cause orthostatic hypotension).

What should the nurse do to aid adverse effects of the cardiovascular system?

•Instruct patient's about dizziness and change positions slowly.

•Check blood pressure and heart rate prior to medication administration.

What adverse effects are in the Gastrointestinal system?

•can result from irritation to GI tract.

•too much NSAIDS can cause GI upset ( take with food)

•Opioids can cause slowing of peristalsis, nausea, and sedation.

What adverse effects that can happen in Hematologic system ?

(conditions or disorders related to the blood)

Bone marrow suppression- typically with anticancer medications

What should the nurse do in order to aid adverse effects in the Hematologic system?

•Monitor for bleeding (bruising, discoloration in urine/stool, petechiae, bleeding gums)

•Notify provider if these occur

What is the Extrapyramidal system?

regulates muscle tone and posture

Controls involuntary movements, such as walking, running, and blinking

What adverse effects can happen in the Extrapyramidal system?

•Abnormal body movements including tremors, rigidity, and spastic movements

Associated with meds that affect the CNS

What is immunosuppression ?

a state in which the body's immune system is weakened or suppressed, making it less effective at fighting infections and other diseases.

What adverse effects can during immunosuppression?

•Decreased or absent immune response

•Immunosuppressant medications (steroids) can mask infection and delay wound healing

What is Hepatotoxicity? And what can happen?

Toxicity to the liver!

•Damage to liver cells can impair medication metabolism and cause accumulation in the body or alter LFT's (liver function test).

What should the nurse do if a patient has Hepatotoxicity?

•Draw LFT's on patients starting a hepatotoxic drug.

-Monitor for abdominal pain, jaundice, dark urine, and fatigue

What is Nephrotoxicity? And what can happen ?

Toxicity to the Kidneys ( usually from antimicrobials and NSAIDs)

•Impaired kidney function leads to decreased excretion and accumulation

As a nurse what should you do if your patient has Nephrotoxicity?

Watch out for urine output changes, increased BUN (Blood Urea Nitrogen) and Creatinine

What is poisoning?

•When an overdose of a drug damages multiple systems

•Can be fatal

•Treatment varies based on drug

Do Hypersensitivity and Allergies mean the same thing? Y/N?

YES duh

True or false? Hypersensitivity/Allergies can happen to an individual who has PREVIOUSLY been exposed to the medication and has developed antibodies.

TRUE

Why do Rapid or immediate hypersensitivity happen? Explain the physiology?

overproduction of IgE antibodies resulting in inflammation, histamine release, and release of eosinophils, mast cells, and basophils.

What are mild allergies treated with ? (med.)

diphenhydramine (Benadryl)

What is Angioedema?

SEVERE allergic reaction that affects deep tissue, usually involves lips/face/neck (face looks very swollen)

What Medication is used for Angioedema ?

Common meds: ACE inhibitors

What are S&S of Anaphylactic Shock?

•Swelling eyes, face, mouth and throat

•Shortness of breath/wheezing

•Rapid heart rate

•Low blood pressure

•Rash

•Pruritis

What Tx are used for Anaphylactic Shock?

Epinephrine (1:1,000) and diphenhydramine

True or false? Anaphylactic Shock can usually occur after the 2nd exposure?

TRUE (needs to be expose first in order for the antigens to make antibodies against the drug)

What is Stevens-Johnson Syndrome (SJS)

A rare, serious disorder of the skin and mucous membranes, causing the skin to peel. usually happens 1-2 weeks of drug exposure. may experience upper respiratory infection and chill & fever.

what is Stomatitis?

Inflammation of the mucous membranes

What are Superinfections

Breakdown of body's normal flora

What is Blood Dyscrasia?

any disorder or abnormality of the blood more specifically:Bone marrow suppression

What is Digoxin used for?

treats heart failure and an irregular heartbeat

What is the scale measured for Digoxin?

Digoxin level (0.8-2 ng/mL)

Heart failure: 0.5 to 1 ng/mL

Atrial fibrillation: 2 ng/mL or lower

what are the electrolytes that are important to measure while using digoxin?

•Hypokalemia, hypomagnesemia, and hypercalcemia enhance toxicity

What are the Serum creatinine levels in considerations of digoxin?

-0.7-1.3 mg/dl males,

-0.6-1.1mg/dL females

What does Warfarin (Coumadin) do for the body ?

is an anticoagulant, or "blood thinner,

What does " International Normalized Ratio (INR)" mean ?

•how long for blood to clot

•Normal range is 0.8-1.2 seconds

•If taking warfarin, want INR to be 2-3 seconds

USED FOR Warfarin

What should you test when it comes to NSAIDs

Serum creatinine!!!

(0.7-1.3 mg/dl males)

(0.6-1.1mg/dL females)

What are some risk factors from taking NSAIDs

renal disease & injury

What is the complete blood count?

(platelets: 150,000 -400,000/mm 3)

what are the AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) function?

are enzymes found primarily in the liver; measuring how well the liver is functioning.

what are the scales of AST and ALT ?

-AST: 10-40 units/L

- ALT: 7-56 units/L